Medium-term outcomes of selective dorsal cryoablation in medically refractory lifelong premature ejaculation: a 24-month follow-up study

Resultados a medio plazo de la crioablación dorsal selectiva en la eyacu-lación precoz de toda la vida refractaria al tratamiento médico: un estudio de seguimiento de 24 meses

Background: The study aimed to clarify the role of selective dorsal cryoablation (SDC) in the management of medical treatment-resistant lifelong premature ejaculation (PE), and evaluate the permanence of SDC treatment effectiveness with results from 24 months. Methods: Patients who were diagnosed with lifelong PE and underwent the SDC procedure were considered for inclusion in the study. Patients’ characteristics, success, and complications of SDC were noted. Intravaginal Ejaculation Latency Time (IELT) and Premature Ejaculation Diagnostic Tool (PEDT) were recorded pre-procedure and during follow-ups. To clarify the impact of SDC on IELT and PEDT during follow-up, IELT and PEDT scores at 3 months, 6 months, 12 months, 18 months, and 24 months were recorded and compared. Also, preoperative factors that affected post-SDC outcomes were analysed. Results: A total of 47 patients were evaluated, and at the 12 months follow-up, 83.0% (n = 39) of the patients met the defined success criteria for the SDC procedure. The mean IELT increased from 48.6 ± 11.1 seconds preoperatively to 250.0 ± 65.3 seconds at 3 months (p = 0.001), then gradually declined over time, measuring 169.5 ± 48.8 seconds at 24 months (p = 0.001, η² = 0.911). Similarly, the mean PEDT score showed a significant reduction from 17.2 ± 2.3 at baseline to 7.3 ± 2.1 at 3 months and then increased slightly over time to 8.8 ± 2.2 at 24 months (p = 0.001, η² = 0.880). Conclusions: Within the limitations of this retrospective single-arm study, SDC was associated with improvements in IELT and PEDT scores in patients with medically refractory lifelong PE. However, these findings should be interpreted with caution, as the absence of a control group limits causal inference and the observed improvements may be partially influenced by nonspecific effects such as placebo response or regression to the mean.

Resumen

Antecedentes: Aclarar el papel de la crioablación dorsal selectiva (SDC) en el tratamiento de la eyaculación precoz (EP) de toda la vida resistente al tratamiento médico, y evaluar la permanencia de la eficacia del tratamiento con SDC a partir de los resultados obtenidos a los 24 meses. Métodos: Se consideró la inclusión en el estudio de pacientes a los que se les había diagnosticado eyaculación precoz de toda la vida y que se habían sometido a la SDC. Se registraron las características de los pacientes, así como el éxito y las complicaciones de la SDC. Se registraron el tiempo de latencia de la eyaculación intravaginal (IELT) y la puntuación de la herramienta de diagnóstico de la eyaculación precoz (PEDT) antes de la intervención y en las visitas de seguimiento. Para aclarar el impacto de la SDC en el IELT y el PEDT durante el seguimiento, se registraron y compararon las puntuaciones del IELT y el PEDT a los 3, 6, 12, 18 y 24 meses. Asimismo, se analizaron los factores preoperatorios que afectaban a los resultados tras la SDC. Resultados: Se evaluó a un total de 47 pacientes y, en el seguimiento a los 12 meses, el 83.0% (n = 39) de los pacientes cumplía los criterios de éxito definidos para la intervención de SDC. La media del IELT aumentó de 48.6 ± 11.1 segundos antes de la intervención a 250.0 ± 65.3 segundos a los 3 meses (p = 0.001), para luego disminuir gradualmente con el tiempo, situándose en 169.5 ± 48.8 segundos a los 24 meses (p = 0.001, η² = 0.911). De manera similar, la puntuación media en la escala PEDT mostró una reducción significativa, pasando de 17.2 ± 2.3 al inicio del estudio a 7.3 ± 2.1 a los 3 meses, para luego aumentar ligeramente con el tiempo hasta alcanzar 8.8 ± 2.2 a los 24 meses (p = 0.001, η² = 0.880). Conclusiones: Dentro de las limitaciones de este estudio retrospectivo de un solo grupo, la SDC se asoció con mejoras en las puntuaciones del IELT y el PEDT en pacientes con eyaculación precoz de toda la vida refractaria al tratamiento médico. Sin embargo, estos hallazgos deben interpretarse con cautela, ya que la ausencia de un grupo de control limita la inferencia causal y las mejoras observadas pueden verse parcialmente influidas por efectos no específicos, como la respuesta al placebo o la regresión a la media.

IELT; Lifelong premature ejaculation; PEDT; Premature ejaculation; Selective dorsal cryoablation

Palabras Clave
IELT; Eyaculación precoz de toda la vida; PEDT; Eyaculación precoz; Dorsal selectiva

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